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Learn About CHIP in Florida

Florida CHIP, referred to as Florida KidCare within the state, is a free to low-cost health insurance program that provides qualifying uninsured children with comprehensive coverage and health insurance benefits. In Florida, the CHIP insurance program is broken down into four separate programs beneath the KidCare umbrella, including Medicaid for children, so it is important to review each program in order to determine the differences between these programs and which program your child will likely qualify for.

The children’s health insurance program has eligibility requirements concerning residency, age, income and citizenship, however, some of the programs within KidCare will have additional requirements. Therefore, it is important to review all of these eligibility requirements in order to better prepare yourself for the application process and save yourself time and hassle down the road. If approved for coverage, it is also important to know that coverage will be provided for a set beneficiary period before you will need to renew your child’s benefits.

What is CHIP in Florida?

Created in 1997, Florida CHIP Medicaid provides health insurance to children with income levels up to 200 percent of the current federal poverty line. While the program is recognized on a national level, it is worth knowing that each state determines certain parts of its own state program within the guidelines that have been established by the federal government. Therefore, CHIP can be different from one state to the next.

In Florida, health insurance for kids is divided up into four different plans that are governed by the Florida KidCare program. Therefore, you are strongly encouraged to review each of these plans in order to determine the KidCare program that your child may qualify for. In Florida, KidCare components are:

  • Medicaid for Children. Medicaid for children between the ages of 0 and 18 years whose family has little to no income. There are no out of pocket costs associated with this KidsCare program.
  • MediKids. This KidsCare plan is designed to provide low cost health insurance to children between the ages of 1 and 4 years that meet income limits that are higher than that of Medicaid.
  • Healthy Kids. This KidsCare plan is designed to provide low cost health insurance to children between the ages of 5 and 18. Similarly to MediKids, income limits are higher than those required to receive Medicaid benefits.
  • Children’s Medical Services Managed Care Plan. This KidsCare plan is similar to Healthy Kids, except that it is for children between the ages of 1 and 18 that have special health care needs. Copayment amounts are different from this program in comparison to other KidsCare plans.

Who does Florida CHIP cover?

If you would like to submit a CHIP application in Florida, it is important to review the eligibility requirements associated with the Florida KidCare programs in order to determine which program your child may qualify for.

CHIP eligibility requirements will require children to be younger than the age of 19, a resident of Florida and either a United States citizen or a qualified legal immigrant. Some of the qualifying legal immigrant statuses include refugee, asylee, Cuban/Haitian entrant, an individual granted withholding of deportation or removal, victims of human trafficking, lawful permanent residents and unmarried dependents of non-citizens serving in the U.S. military. Children may not have any other form of health insurance in order to be eligible for KidCare, except when it comes to Medicaid for Children.

For CHIP benefits, children must be younger than the age of 19 years. However, KidCare is split into four different health insurance programs and a few of these programs will have more specific age requirements.

CHIP requires families to meet income levels for all four KidCare programs. However, each program will vary on the amount of income that a family is allowed to have while still qualifying for KidCare. The overall program allows families to have up to 200 percent of the current year’s federal poverty line while still qualifying for assistance. Income levels will determine which KidCare programs a child may be eligible for, which will ultimately determine the cost that parents can expect to pay for coverage.

Lastly, the Children’s Medical Services Managed Care Plan will require a child to have special health care needs in order to be eligible for this plan. To learn more about CHIP, applicants can download our free guide to CHIP today.

How to Apply for CHIP in Florida

By applying for CHIP coverage online in Florida, you need not wait additional time for your application to be processed due to postage times. Applying online is convenient and it can be done from the comfort of your own home in as little as 30 minutes. If you need help with your application or if you would rather request a paper application, you can contact Florida KidCare during normal business hours. Should you wish to apply by mail, KidCare can send you an application.

When submitting a CHIP application, you may be asked to provide additional documentation to support the information that you provide on your application. This documentation includes:

  • Proof of income for your household.
  • Proof of citizenship or immigration status.
  • Proof of identity.
  • Information regarding any job-related health insurance that may be available to your family.

What is included with Florida CHIP coverage?

Once approved for CHIP insurance in Florida, your child will have access to medical services that are needed at each stage of growth and development. Each of the KidCare plans offers comprehensive health insurance benefits, including, but not limited to:

  • Doctor visits.
  • Immunizations.
  • Preventive care.
  • Vision and hearing services.
  • Prescription drug coverage.
  • Dental care.
  • Emergency services.
  • Mental and behavioral health services.

There is a CHIP program in every state within the U.S. While a program exists nationally, each state is in charge of setting certain terms of coverage. Therefore, CHIP coverage options offered in Florida will most likely differ from any other state program that you may be familiar with.

How much is CHIP health insurance in Florida?

If you qualify for CHIP Medicaid in Florida, you will not receive a monthly premium or coinsurance payments. While most families that apply for coverage do qualify for free KidCare, many others will receive a small monthly premium as well as additional fees for coverage. Additionally, the Healthy Kids program has additional copayments that are due at the time of service. The amount that you can expect to pay on any of the KidCare programs will be based upon your family’s income levels at the time of your application.

How long do CHIP benefits last in Florida?

After Florida KidCare approves your CHIP application, your child will generally be eligible to receive 12 months of continuous benefits and coverage. However, benefits can end prematurely for nonpayment or if your child no longer qualifies. Disqualification can include aging out of the program on his or her 19th birthday or moving out of the state. Changes to income can also lead to disqualification from the program

When your CHIP insurance is nearing its expiration date, you may renew your coverage by submitting a renewal application to KidCare. This must be done each year in a timely manner in order to retain benefits and avoid any lapses in coverage. Once a renewal application has been approved, coverage will be extended for an additional 12-month period. There is no limit to the amount of times that you can renew benefits for an eligible child. To learn more about the benefits of the CHIP program, you can download our comprehensive guide today.